Remote Credentialing Specialist — NPDB/NCQA Focus

Medix; United States; Remote; USD 60,000 - 90,000; Full time

Job summary

Medix is seeking a Provider Credentialing Specialist to support core credentialing and recredentialing operations for health plan networks. This role focuses on primary source verification, data integrity, and compliance with NCQA, NPDB, and CMS guidelines.

The position is 100% remote on a contract basis, with equipment provided. Responsibilities include data management, verification tracking, committee support, and maintaining HIPAA confidentiality, serving as a liaison with IPAs and

Qualifications

• Minimum of 1 year of hands-on experience processing provider credentialing applications.
• Proficiency in database management, word processing, and spreadsheets.
• Strong organizational, written and verbal communication, and ability to work independently in a remote environment.

Responsibilities

• Data management, entry, and maintenance of practitioner data in health plan databases and storage systems (e.g., OnBase).
• Perform primary source verifications and investigations with regulatory bodies and boards.
• Maintain knowledge of NCQA, NPDB, and CMS guidelines and compliance.
• Handle high-volume inquiries via email and phone, liaising between organization, IPAs, delegates, and practitioner offices.
• Review monthly recredentialing reports to meet deadlines.
• Prepare written summaries/reports for the Credentialing Committee meetings.
• Maintain strict HIPAA compliance and confidentiality of all practitioner records.

Skills

Data management

Word processing

Spreadsheets

Organizational skills

Communication

Education

Associate degree preferred

NAMSS CPCS certification (a plus)

Job description

Medix is seeking a Provider Credentialing Specialist to support core credentialing and recredentialing operations for health plan networks. This role focuses on primary source verification, data integrity, and compliance with NCQA, NPDB, and CMS guidelines.

The position is 100% remote on a contract basis, with equipment provided. Responsibilities include data management, verification tracking, committee support, and maintaining HIPAA confidentiality, serving as a liaison with IPAs and